FORM 1023-EZ for THE SIOUXLAND LUTHERANS IN MISSION MINISTRY

Field Data
EIN 82-2312358
Case Number EO-2018078-000501
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE SIOUXLAND LUTHERANS IN MISSION MINISTRY
Organization’s Mailing Address 3101 HAMILTON BLVD
City SIOUX CITY
State IA
ZIP 51104
Accounting period End 12
Primary contact name JOHN B ANDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LARRY BOOK
DIRECTOR/PRESIDENT
6350 GOLFVIEW POINT
SIOUX CITY IA 51106

Officer/Director/Trustee Two

LARRY JOINES
DIRECTOR/VICE PRESIDENT
18 24TH ST
SIOUX CITY IA 51104

Officer/Director/Trustee Three

DON SCHULTZ
DIRECTOR/TREASURER
512 W CLIFTON
SIOUX CITY IA 51104

Officer/Director/Trustee Four

RALPH SCHROEDER
DIRECTOR/SECRETARY
2970 ISABELLA ST
SIOUX CITY IA 51103

Officer/Director/Trustee Five

STEVE SEGARTBART
DIRECTOR
33701 FRELON DR
SIOUX CITY IA 51108

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/21/17
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X21 - Protestant
Organization’s purpose Charitable: No
Religious: Yes
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LARRY BOOK
Signature Title DIRECTOR/PRESIDENT
Signature Date 3/16/18

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